You may include any other information you feel
may be helpful regarding your adoption; such as, place of birth, name of
hospital, your birth name, where your adopted parents lived at the time
they adopted you, if you were in foster care, etc.

You may then email, fax or mail your inquiry
to the Adoption Registry Coordinator.

If you are seeking identifying
information (to be matched with a birth relative or adoptee),
complete sections A and B.

Complete section D; set appointment for
counseling session. You need to receive a minimum of one (1) hour of
counseling. If you live within Arkansas, you will need to contact
the Adoption Specialist that serves your county. For a list of
Adoption Specialist’s in Arkansas click here
(there is no fee for counseling with an Arkansas DHS/DCFS Adoption
Specialist). If you live outside Arkansas, you
will need to find a social worker with a licensed agency in your
state (the agency may charge a fee for the counseling and this will
be your responsibility). The social worker
will need to counsel with you on issues related to finding the birth
relative; such as, what are the pros and cons of finding the birth
relative, what if…. The counselor will have to complete section D on
your affidavit form, so be sure to take it with you to your
appointment.

Complete section E; get your form
notarized.

You will need to send a money order or
cashier's check for
$20.00, if you are seeking to be placed on the Mutual Consent
Voluntary Adoption Registry and to receive non-identifying
information.

Mail the notarized, completed affidavit
form with money order or cashier’s check to:

If you are seeking both
identifying information and non- identifying information
follow the steps above for identifying information and
send one money order or cashier's check for
$25.00.

* Be sure to notify our office of any address,
phone number or email
change.

STEP 3: Receive Response

You will receive your response by certified
mail.

The Adoption Registry Coordinator will process
the affidavit forms in the order in which they are received. If you have
a medical emergency, please contact Tracy Dickinson the Adoption Registry
Coordinator at 501-682-8762 or toll free at 888-736-2820.